'‘I’m Really Isolated Now’: When Elders Have to Fight Coronavirus Alone' diff viewer (1/2)

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‘I’m Really Isolated Now’: When Elders Have to Fight Coronavirus Alone	‘I’m Really Isolated Now’: When Elders Have to Fight Coronavirus Alone
2020-03-18 16:54:08 UTC	2020-06-15 05:24:44 UTC (3 months later)
At the Stanley M. Isaacs Neighborhood Center on Manhattan’s Upper East Side on Monday morning, a trickle of older New Yorkers, some pushing walkers or riding in mobility scooters, arrived to bad news. All group activities were canceled. Lunch was strictly to go.	At the Stanley M. Isaacs Neighborhood Center on Manhattan’s Upper East Side on Monday morning, a trickle of older New Yorkers, some pushing walkers or riding in mobility scooters, arrived to bad news. All group activities were canceled. Lunch was strictly to go.
A worker wearing a plaid shirt and a surgical mask handed a meal to a woman, then urged her to move along: “You can’t hang out at the center today.”	A worker wearing a plaid shirt and a surgical mask handed a meal to a woman, then urged her to move along: “You can’t hang out at the center today.”
Anna Reifman, 69, took a meal to warm in her toaster oven. Ms. Reifman, like many at the center, lives alone.	Anna Reifman, 69, took a meal to warm in her toaster oven. Ms. Reifman, like many at the center, lives alone.
“I’m really isolated now,” she said. “This isn’t just about lunch. I come here to talk to people other than my cat.”	“I’m really isolated now,” she said. “This isn’t just about lunch. I come here to talk to people other than my cat.”
New York is an aging city, and in many ways, it’s a good place to be an older person: There is plenty of public transportation and ample medical care. But the city is unprepared for what it faces today. New York has 1.73 million residents over age 60, more than the total population of Boston and San Francisco combined, with a demographic profile that is getting poorer and older. The coronavirus pandemic stretches the gaps in a system already under pressure.	New York is an aging city, and in many ways, it’s a good place to be an older person: There is plenty of public transportation and ample medical care. But the city is unprepared for what it faces today. New York has 1.73 million residents over age 60, more than the total population of Boston and San Francisco combined, with a demographic profile that is getting poorer and older. The coronavirus pandemic stretches the gaps in a system already under pressure.
Shortages in supermarkets, closures in public facilities — all take an extra toll on elders, especially those with limited means: One in five New Yorkers over age 65 lives in poverty, twice the national average. The difficulties cascade: When schools close, home-care workers have to stay with their children, leaving frail elders isolated in homes they cannot manage.	Shortages in supermarkets, closures in public facilities — all take an extra toll on elders, especially those with limited means: One in five New Yorkers over age 65 lives in poverty, twice the national average. The difficulties cascade: When schools close, home-care workers have to stay with their children, leaving frail elders isolated in homes they cannot manage.
All of it rests on an especially fragile work force of volunteers and low-wage workers who provide essential meals, home care, and social companionship to elders at home — exposed to long subway rides and managing their own child care. If they falter, there is often no net below for their clients.	All of it rests on an especially fragile work force of volunteers and low-wage workers who provide essential meals, home care, and social companionship to elders at home — exposed to long subway rides and managing their own child care. If they falter, there is often no net below for their clients.
For 30,000 elders each day, senior centers were an outlet from their homes. And now, by order of the mayor, all on-site activities are closed, though the centers can still provide meals to go.	For 30,000 elders each day, senior centers were an outlet from their homes. And now, by order of the mayor, all on-site activities are closed, though the centers can still provide meals to go.
“I started crying when I told the seniors we were closing down,” said Judy Zangwill, executive director of Sunnyside Community Services, which closed its senior center except for pickup food service last Friday, ahead of instructions from the city. “I heard audible moans.”	“I started crying when I told the seniors we were closing down,” said Judy Zangwill, executive director of Sunnyside Community Services, which closed its senior center except for pickup food service last Friday, ahead of instructions from the city. “I heard audible moans.”
It is a terrible irony of the virus: that for older adults, steps to prevent the spread of Covid-19 increase the risks of social isolation, which carries its own devastating health effects. A study by the AARP compared the effects of prolonged isolation to those of smoking 15 cigarettes a day.	It is a terrible irony of the virus: that for older adults, steps to prevent the spread of Covid-19 increase the risks of social isolation, which carries its own devastating health effects. A study by the AARP compared the effects of prolonged isolation to those of smoking 15 cigarettes a day.
Normally programs for elders aim to increase human contact. Now that contact is potentially deadly.	Normally programs for elders aim to increase human contact. Now that contact is potentially deadly.
Nursing homes and assisted-living buildings, by order of the city’s health department, banned visitors, including in many cases residents’ private aides. Public libraries, houses of worship, neighborhood cafes — all social spots for elders — are also closed, pushing older people back into what are often lonely apartments: 30 percent of New Yorkers over 65, and 43 percent of those over 85, live alone, according to the Department for the Aging.	Nursing homes and assisted-living buildings, by order of the city’s health department, banned visitors, including in many cases residents’ private aides. Public libraries, houses of worship, neighborhood cafes — all social spots for elders — are also closed, pushing older people back into what are often lonely apartments: 30 percent of New Yorkers over 65, and 43 percent of those over 85, live alone, according to the Department for the Aging.
Sarah Arico, a regular at Sunnyside’s senior center, said the closing was “very hard to deal with emotionally.” She goes to the center for photography, for exercise classes, for the mental health group and “a good lunch.”	Sarah Arico, a regular at Sunnyside’s senior center, said the closing was “very hard to deal with emotionally.” She goes to the center for photography, for exercise classes, for the mental health group and “a good lunch.”
Last Friday, all of that came to a halt. “It is more isolating,” she said. Without the center, she was turning her attention to her dog and to phone calls with friends.	Last Friday, all of that came to a halt. “It is more isolating,” she said. Without the center, she was turning her attention to her dog and to phone calls with friends.
When she picked up food at the center, she said, the staff instructed everyone on line to stand six feet apart.	When she picked up food at the center, she said, the staff instructed everyone on line to stand six feet apart.
“Everybody was freaking out.”	“Everybody was freaking out.”
But Ms. Arico said that she was making sure she walked outside, using physical activity to bolster her mental health.	But Ms. Arico said that she was making sure she walked outside, using physical activity to bolster her mental health.
“It’s a completely different way of living,” she said. “But I know we are going to get through this. I try to say, nothing is forever, not the good times, not the bad times. We all try to get through.”	“It’s a completely different way of living,” she said. “But I know we are going to get through this. I try to say, nothing is forever, not the good times, not the bad times. We all try to get through.”
As much as the activities and the hot meals, senior centers provide structure in lives that may not otherwise have it, said Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College. “The way we remember to do something is that it’s tied to something else,” Ms. Finkelstein said. “When that gets disrupted, it disrupts when we eat, which disrupts our sleep, which disrupts whether we take our medications.	As much as the activities and the hot meals, senior centers provide structure in lives that may not otherwise have it, said Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College. “The way we remember to do something is that it’s tied to something else,” Ms. Finkelstein said. “When that gets disrupted, it disrupts when we eat, which disrupts our sleep, which disrupts whether we take our medications.
“We see this with the way older people experience delirium in the hospital after just a few days of disruption. I’m not saying the current disruption will come to that, but once the disruption starts, it’s very difficult to dam it.”	“We see this with the way older people experience delirium in the hospital after just a few days of disruption. I’m not saying the current disruption will come to that, but once the disruption starts, it’s very difficult to dam it.”
At JASA’s Club 76 on Manhattan’s Upper West Side, run by the Jewish Association Serving the Aging, Stu Lahn said, “My family is being very hard on me because I’m not being as careful as they would want me to be.” Mr. Lahn said he was most disturbed by not knowing what would happen next. He could replace his social activities at the center using the telephone, but the uncertainty made him feel a loss of control, which in older people can be particularly damaging.	At JASA’s Club 76 on Manhattan’s Upper West Side, run by the Jewish Association Serving the Aging, Stu Lahn said, “My family is being very hard on me because I’m not being as careful as they would want me to be.” Mr. Lahn said he was most disturbed by not knowing what would happen next. He could replace his social activities at the center using the telephone, but the uncertainty made him feel a loss of control, which in older people can be particularly damaging.
	Updated June 12, 2020
	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“What’s hard is thinking about how long it’s going to last,” he said. “Tomorrow and tomorrow and tomorrow — it’s the unknown that’s scary.”	“What’s hard is thinking about how long it’s going to last,” he said. “Tomorrow and tomorrow and tomorrow — it’s the unknown that’s scary.”
Mr. Lahn, who is 79, normally runs the center’s Monday bingo program with an older woman who survived the Holocaust. (She did not feel up to being interviewed for this article.) Since the center closed last week, he has been checking up on her by telephone. “I’m wondering at times whether the Holocaust survivors are better prepared than we are for this,” he said. “I’ve never experienced anything like this.”	Mr. Lahn, who is 79, normally runs the center’s Monday bingo program with an older woman who survived the Holocaust. (She did not feel up to being interviewed for this article.) Since the center closed last week, he has been checking up on her by telephone. “I’m wondering at times whether the Holocaust survivors are better prepared than we are for this,” he said. “I’ve never experienced anything like this.”
Stephanie Cacioppo, an assistant professor of psychiatry and behavioral neuroscience at the University of Chicago, who studies loneliness and social isolation, said that the sense of losing control in the pandemic was both harmful and treatable. Social distance need not lead to social isolation, she said. “You can train your brain like you train your body,” she said.	Stephanie Cacioppo, an assistant professor of psychiatry and behavioral neuroscience at the University of Chicago, who studies loneliness and social isolation, said that the sense of losing control in the pandemic was both harmful and treatable. Social distance need not lead to social isolation, she said. “You can train your brain like you train your body,” she said.